Guidelines to ease insomnia and other sleep disorders

WASHINGTON - The British Association for Psychopharmacology (BAP) has released up-to-the-minute guidelines regarding insomnia and other sleep disorders to guide psychiatrists and physicians dealing with this problem.

Sleep experts agree that insomnia is a condition of unsatisfactory sleep, either in terms of sleep onset, sleep maintenance or early waking.

They also agree that insomnia is a disorder that impairs daytime well-being and subjective abilities and functioning, and so can be considered a ‘24-hour’ disorder.

Insomnia can also be viewed as a syndrome similar to pain, because it is subjective and its diagnosis is through clinical observations rather than measurements. In some cases physicians will be unable to pinpoint a cause, although this doesn’t prevent diagnosis.

Stress, life changes, a new baby, or shift work are typical factors that can trigger insomnia, but for some people this acute insomnia persists into a chronic state.

Anxiety about sleep, maladaptive sleep habits and the possibility of an underlying vulnerability in sleep regulating mechanisms are all likely causes, as are other co-morbid disorders such as anxiety and depression, and diseases including cancer or arthritis.

The good news is that insomnia can often be improved with specialist cognitive behavioral therapy (CBT) targeted at insomnia, which is as effective as prescription medications for short-term treatments for chronic insomnia.

In addition, CBT is more likely to have a longer-lasting effect than drug treatment.

Circadian rhythm disorders occur when our internal clocks don’t match our daily lives.

Caused most often by shift work and jet lag, some people also routinely have difficulty going to bed before two or three AM and waking up in the morning on time (delayed sleep phase syndrome).

Others get cumulatively later as time goes, a condition known as free running sleep disorder.

Night terrors, sleep walking and violent behaviour at night are known as ‘parasomnias.’

Physicians may need to refer patients experiencing these distressing episodes to a specialist sleep centre for polysomnography and video recording for a correct diagnosis, and to discover whether the attacks occur during REM (rapid eye movement) or non-REM sleep, which can mean differing treatments.

The study has been published in the Journal of Psychopharmacology, published by SAGE. (ANI)